Suicide in young people: screening, risk assessment, and intervention

Abstract

Suicide is the fourth leading cause of death among young people worldwide and the third leading cause of death among those in the US. This review outlines the epidemiology of suicide and suicidal behavior in young people. It discusses intersectionality as an emerging framework to guide research on prevention of suicide in young people and highlights several clinical and community settings that are prime targets for implementation of effective treatment programs and interventions aimed at rapidly reducing the suicide rate in young people. It provides an overview of current approaches to screening and assessment of suicide risk in young people and the commonly used screening tools and assessment measures. It discusses universal, selective, and indicated evidence based suicide focused interventions and highlights components of psychosocial interventions with the strongest evidence for reducing risk. Finally, the review discusses suicide prevention strategies in community settings and considers future research directions and questions challenging the field.

Fig 1

Flow diagram of included articles

Fig 2

Suicide rates by age and sex in young people aged 5-19 years between 2016 and 2020 in the US; no deaths from suicide were observed in children aged 5-6 years

Fig 3

Comparison of suicide rates between young black and white people in the US between 2016 and 2020, by age (5-12 v 13-17 years). Among children aged 5-12 years, the black to white incidence rate ratio (IRR) was 1.46 (95% confidence interval 1.23 to 1.73). Among young people aged 13-17 years, the black to white IRR was 0.56 (0.52 to 0.60)

Fig 4

Comparison of the prevalence of attempted suicide during the previous year by sexual identity and sex of sexual contacts of high school students in the US, 2019, Youth Risk Behavior Survey. LGB=lesbian, gay, or bisexual

Fig 5

Public health model for suicide prevention in young people